scholarly journals A COMPARATIVE STUDY ON DRUG USE OF ANTIMICROBIAL AGENTS IN MEDICAL AND SURGICAL INTENSIVE CARE UNITS OF A TERTIARY CARE HOSPITAL.

2018 ◽  
Vol 11 (1) ◽  
pp. 310
Author(s):  
Nimin Paul ◽  
Santhosh Kumar V
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clavulanic Acid ◽  
Antimicrobial Agents ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Surgical Intensive Care Unit ◽  
Care Hospital ◽  
Total Drug ◽  
Surgical Intensive Care

 Objective: To identify the pattern of drug utilization of antimicrobials in prescriptions of patients admitted at medical intensive care unit (MICU) and surgical intensive care unit (SICU) department and to analyze the utilization of different classes of drugs.Methods: A prospective observational study was carried out in 10 bedded medical and surgical intensive care unit (ICU) of tertiary care hospital, Adayar, from October 1st 2016 to March 1st 2016. The study was performed in 100 prescriptions. The relevant data on drug prescription of each patient were collected from in-patient records. The demographic data, disease data, and the utilization of different classes of antimicrobial agents (AMAs) were analyzed.Results: In MICU, a total of 648 drugs were prescribed during the period of stay and AMAs accounted for 15% of total drug. The average length of stay was found to be 8 (±8.73). The mean number of drugs received by patients is 11.6 ± 2 drugs. The most frequently prescribed AMAs were ceftriaxone followed by meropenem and clindamycin. Cephalosporin is commonly prescribed due to their relatively lower toxicity and broader spectrum activity. The generally prescribed AMA combination was amoxicillin + clavulanic acid (32.50%) and piperacillin + tazobactam (27.50%). The laboratory reported positive cultures for 30 patients. The most prevailing organisms were Escherichia coli (50%). In SICU, a total of 780 drugs were prescribed during the period of stay and AMAs accounted for 18% of total drug. An average of 5 (±2.0) drugs was prescribed for each patient and each prescription contains an average of 2 (±0.9) AMAs. The results indicated that ceftriaxone was the most commonly prescribed AMAs (22%), followed by meropenem (18%), ciprofloxacin (18%), and colistin (8%). A total of five AMA combination therapies were used in SICU. Among them, piperacillin+clavulanic acid (36.84%) was the most commonly prescribed combination. In the study, 30 (60 %) cases had microbial growth and have performed sensitivity test.Conclusion: A wide class and percentage of AMAs were prescribed in ICUs. There is a need of antimicrobial agent’s usage guidelines and restriction policies for the rational prescribing of antimicrobials in critically ill patients.

scholarly journals A COMPARATIVE STUDY ON DRUG USE OF ANTIMICROBIAL AGENTS IN MEDICAL AND SURGICAL INTENSIVE CARE UNITS OF A TERTIARY CARE HOSPITAL.

2018 ◽  
Vol 11 (1) ◽  
pp. 310
Author(s):  
Nimin Paul ◽  
Santhosh Kumar V
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clavulanic Acid ◽  
Antimicrobial Agents ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Surgical Intensive Care Unit ◽  
Care Hospital ◽  
Total Drug ◽  
Surgical Intensive Care

 Objective: To identify the pattern of drug utilization of antimicrobials in prescriptions of patients admitted at medical intensive care unit (MICU) and surgical intensive care unit (SICU) department and to analyze the utilization of different classes of drugs.Methods: A prospective observational study was carried out in 10 bedded medical and surgical intensive care unit (ICU) of tertiary care hospital, Adayar, from October 1st 2016 to March 1st 2016. The study was performed in 100 prescriptions. The relevant data on drug prescription of each patient were collected from in-patient records. The demographic data, disease data, and the utilization of different classes of antimicrobial agents (AMAs) were analyzed.Results: In MICU, a total of 648 drugs were prescribed during the period of stay and AMAs accounted for 15% of total drug. The average length of stay was found to be 8 (±8.73). The mean number of drugs received by patients is 11.6 ± 2 drugs. The most frequently prescribed AMAs were ceftriaxone followed by meropenem and clindamycin. Cephalosporin is commonly prescribed due to their relatively lower toxicity and broader spectrum activity. The generally prescribed AMA combination was amoxicillin + clavulanic acid (32.50%) and piperacillin + tazobactam (27.50%). The laboratory reported positive cultures for 30 patients. The most prevailing organisms were Escherichia coli (50%). In SICU, a total of 780 drugs were prescribed during the period of stay and AMAs accounted for 18% of total drug. An average of 5 (±2.0) drugs was prescribed for each patient and each prescription contains an average of 2 (±0.9) AMAs. The results indicated that ceftriaxone was the most commonly prescribed AMAs (22%), followed by meropenem (18%), ciprofloxacin (18%), and colistin (8%). A total of five AMA combination therapies were used in SICU. Among them, piperacillin+clavulanic acid (36.84%) was the most commonly prescribed combination. In the study, 30 (60 %) cases had microbial growth and have performed sensitivity test.Conclusion: A wide class and percentage of AMAs were prescribed in ICUs. There is a need of antimicrobial agent’s usage guidelines and restriction policies for the rational prescribing of antimicrobials in critically ill patients.

scholarly journals A study of wound infections and its antibiogram in surgical intensive care unit of a tertiary care hospital

2019 ◽  
Vol 5 (7) ◽  
pp. 473-478
Author(s):  
Dr. Upasana Bhumbla ◽  
◽  
Dr. Safaa Muneer Ahmed ◽  
Dr. Dinesh Raj Mathur ◽  
Dr. A.S. Dalal ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Surgical Intensive Care Unit ◽  
Care Hospital ◽  
Wound Infections ◽  
Surgical Intensive Care

Assessing the Prescription Pattern of Antimicrobial Agents in Intensive Care Unit at Tertiary Care Hospital

2020 ◽  
Vol 2 (10) ◽  
pp. 1825-1830
Author(s):  
Avinash Khadela ◽  
Bhavin Vyas ◽  
Nancy Rawal ◽  
Heni Patel ◽  
Sonal Khadela ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antimicrobial Agents ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Prescription Pattern

scholarly journals STUDY OF PRESCRIBING PATTERN OF ANTIMICROBIAL AGENTS IN MEDICINE INTENSIVE CARE UNIT OF A TERTIARY CARE HOSPITAL

2020 ◽  
pp. 136-140
Author(s):  
DUDHE BG ◽  
CHAKRAVORTY ASHISH D ◽  
MANKAR NN ◽  
PISE HN
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antimicrobial Agents ◽  
Tertiary Care Hospital ◽  
Generic Drugs ◽  
Tertiary Care ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Case Record ◽  
Treatment Data

Objective: The objective of the study was to assess the current use of antimicrobial agents (AMAs) and to assess prescription writing as per the WHO guidelines in the medicine intensive care unit (MICU). Methods: The present study was conducted on admitted patients in MICU of a tertiary care hospital. The demographic and clinical treatment data of patients were collected in specially designed pro forma from the case record form. Results: Of 400 patients enrolled in the study, 55.50% were male and 44.50% were female. A common indication of AMAs use was infection (61.75%), symptomatic (21.50%), and prophylactic (10.50%) use. In 65% patients, antimicrobial therapy was considered to be rational. The majority of patients have good recovery (61%). Polypharmacy was seen in 89.75% of patients. The average number of drugs prescribed per patient was 8.84±2.55. 1.90±1.20 was average number of AMAs per patient. Commonest AMAs prescribed are ceftriaxone (27.64%), metronidazole, and amoxicillin+clavulanic acid. Conclusion: This study visibly highlights the practice of polypharmacy, low uses of generic drugs, high usage of antibiotic, and injection. Cephalosporins are the most prescribed AMAs in the ICUs. Remedy of this situation requires regulation, education, awareness, compliance with protocol, and guidelines of AMAs use.

scholarly journals Incidence and risk factors of delirium in surgical intensive care unit

2021 ◽  
Vol 6 (1) ◽  
pp. e000564
Author(s):  
Muhammad Asghar Ali ◽  
Madiha Hashmi ◽  
Waqas Ahmed ◽  
Syed Amir Raza ◽  
Muhammad Faisal Khan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Low Income ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Surgical Intensive Care Unit ◽  
Care Hospital ◽  
Surgical Intensive Care

BackgroundTo evaluate the incidence and modifiable risk factors of delirium in surgical intensive care unit (SICU) of tertiary care hospital in a low-income and middle-income country.MethodsWe conducted a single cohort observational study in patients over 18 years of age who were admitted to the SICU for >24 hours in Aga Khan University Hospital from January to December 2016. Patients who had pre-existing cognitive dysfunction were excluded. Intensive Care Delirium Screening Checklist was used to assess delirium. Incidence of delirium was computed, and univariate and multivariable analyses were performed to observe the relationship between outcome and associated factors.ResultsThe average patient age was 43.29±17.38 and body mass index was 26.25±3.57 kg/m2. Delirium was observed in 19 of 87 patients with an incidence rate of 21.8%. Multivariable analysis showed chronic obstructive pulmonary disease, pain score >4 and hypernatremia were strong predictors of delirium. Midazolam (adjusted OR (aOR)=7.37; 95% CI 2.04 to 26.61) and propofol exposure (aOR=7.02; 95% CI 1.92 to 25.76) were the strongest independent predictors of delirium while analgesic exposures were not statistically significant to predict delirium in multivariable analysis.ConclusionDelirium is a significant risk factor of poor outcome in SICU. There was an independent association between pain, sedation, COPD, hypernatremia and fever in developing delirium.Level of evidenceIV.

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